The rough guide to results based accountability
16
The rough guide to ‘Results Based Accountability’ Bryan Collis WCVA www.wcva.org.uk 0800 2888 329 [email protected]
description
How can RBA work for you?
Transcript of The rough guide to results based accountability
The rough guide to ‘Results Based Accountability’
Bryan Collis
WCVA
www.wcva.org.uk 0800 2888 329 [email protected]
What is RBA?
• Getting from talk to action• Also called Outcomes Based Accountability• Three parts
– Strategic planning based on outcomes or impactPOPULATION ACCOUNTABILITY
– Measuring performance of services that contributePERFORMANCE ACCOUNTABILITY
– Commissioning services that contribute to outcomesRESULTS BASED COMMISSIONING
• Making it fit together
Populations
• Population – All people in Cardiff• Outcome – People in Cardiff are healthy• Indicator – Percentage of people who are obese• Baseline – Statistics are available – 54% of those 16+• Story behind this – The rate is increasing• Partners – Health, Education, Youth, Leisure, Voluntary
Sector, Food outlets, Food industry, Advertising• What works? – Obesity pathway• Action plan - Healthy lifestyle groups, food labeling, etc
Populations
All People in CardiffWHOLE POPULATION
OUTCOME: People in Cardiff
are Healthy
INDICATORObesity Rate
People attending active lifestyle
programme
Contribution
Means
End
PERFORMANCE MEASURE
% People attending losing weight
Turn the curve!
• What is the desired change in the indicator.• Use this to measure success and decide what works.• Use a ‘simple’ abbreviated report to show what is
happening (in your pack)• Think about ‘no cost’ and ‘low cost’ actions as well as ‘off
the wall’ ones to stimulate creativity
PerformanceE
FF
EC
T
How much service did we deliver?
How well did we
deliver it?
How much change/effect
did we produce?
What quality of change/effect
did we produce?
EF
FO
RT
OU
TP
UT
INP
UT
Cause
Effect
QUANTITY QUALITY
Enter title
QUANTITY QUALITY
EF
FO
RT
EF
FE
CT
How much did we do? How well did we do it?
Is anyone better off?
LEASTimportant
Also Very Important
MOSTimportant
Commissioning
• You can purchase services.• You can purchase service quality• You cannot purchase customer outcomes.
• But, you can purchase a contract relationship that maximizes good customer outcomes.
Commissioning
• The most important performance measures– 3 to 5 quality and outcome measures.
• Set up a Continuous Improvement Process– Review meetings concentrate on these measures with a report
similar to the population accountability report using a similar set of questions.
• Performance Partnership between commissioner and service provider– Ask what can the commissioner can do to help
Commissioning
• As a service provider you will have a report card for each contract/service/beneficiary group.
• The most important performance measures– 3 to 5 quality and outcome measures.
• Set up a Continuous Improvement Process– Review meetings concentrate on these measures with a report
similar to the population accountability report using a similar set of questions.
• Performance Partnership between commissioner and service provider– Ask what can the commissioner can do to help
Does it work?
Strengths• Focuses on people, outcomes and change• Can cope with equalities issues• Separates out who is responsible for what• Includes partnership ideas and co-design / co-delivery
Does it work?
Weaknesses• Children’s services in England have implemented OBA
over last 3 years – mixed experience– Courage to stop counting what you have always counted– Needs to be part of a change agenda – not just an add on– Organisational inertia and vested interests
• Needs the right indicators– What if your service doesn’t link to the indicators chosen– What if the indicators are not linked directly to the outcome?
• All examples are people based – what about infrastructure bodies?
Does it work?
Weaknesses• It is based on the dominance of numbers over stories
and the presumed independence of numbers.• Of critical importance are
– The story behind the baseline– The trend and the curve to turn.
And these may be decided behind closed doors by ‘experts’.
Does it work?
Opportunities• Involvement in the partnership discussions about what
the outcomes look like and which indicators should be used.
• Changing relationship between commissioner and provider.
Does it work?
Threats• Outcomes and indicators may be imposed nationally.• If your service cannot demonstrate its contribution to
achieving the outcome(s), then funding may be threatened.
• Service user voice may be reduced – customer is just that – not automatically a citizen.
